FP AND SALMETEROL IN PREVENTING COPD EXACERBATIONS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 背景 COPD代表慢性阻塞性肺疾病。COPD是一个术语，主要是指两种密切相关的呼吸系统疾病，逐渐采取一个人？呼吸困难：慢性支气管炎和/或与气流阻塞相关的肺气肿。 慢性阻塞性肺病没有治愈的方法，只有缓解这种疾病症状的治疗。 获得可研究信息的最简单方法是采取支气管肺泡灌洗（BAL）和/或支气管内活检样本，因为它们含有细胞，蛋白质和其他因子。 本研究的目的是评估轻度至中度COPD受试者在接受标准治疗时的血液和气道，以更好地评估这些标准治疗的效果。 设计和方法 我们建议通过1）在沙美特罗或氟替卡松治疗开始前和2）治疗4周后再次进行支气管镜检查和BAL和支气管内活检，检查轻度至中度COPD患者的粘附和迁移，评估COPD患者血液和气道中性粒细胞群。此时，患者将接受两种药物的联合治疗，并在额外4周治疗后再次接受所有手术。我们假设，在FP治疗患者的活检中检查的中性粒细胞将显示胞质组IVa-磷脂酶A2（gIV-PLA 2）的易位受损，并且这种效应将通过添加沙美特罗而协同放大。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background COPD stands for Chronic Obstructive Pulmonary Disease. COPD is a term that refers mainly to two closely related respiratory disorders that gradually take a person¿??s breath away: chronic bronchitis and/or emphysema associated with airflow obstruction. There is no cure for COPD, only treatment to ease the symptoms of this disease. The easiest way to obtain researchable information is to take a broncoalveolar lavage (BAL) and or endobronchial biopsy sample since they contain cells, proteins and other factors. The purpose of this study is to evaluate the blood and airway of subjects with mild to moderate COPD while undergoing standard treatment to better assess how these standard therapies work. Design and Methods We propose to evaluate blood and airway neutrophil population in COPD patients by examining adhesion and migration in patients with mild to moderate COPD by 1) bronchoscopy with BAL and endobronchial biopsy before the initiation of salmeterol or fluticasone, and 2) again after a period of treatment of 4 weeks. At that point, patients would be placed on the combination of both agents and undergo all procedures again after an additional 4 weeks of treatment. We hypothesize that neutrophils examined in biopsy of patients treated with FP will demonstrate impaired translocation of cytosolic group IVa-phospholipase A2 (gIV-PLA2) and that this effect will be amplified synergistically by addition of salmeterol.